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NBME 20 Answers

nbme20/Block 1/Question#12 (88.9 difficulty score)
A 72-year-old woman with dysphagia is ...
Right kidneyπŸ”,πŸ“Ί
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 +19 
submitted by onyx(43),
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ohcicraT dcut rsloneit.a

consuela_salon  This was the picture that I liked the most for this question. If you imagine that the injury is at the level of the left subclavian vein (LSV) and thoracic duct (TD) crossing each other, maybe it will help you realize that the left breast & left upper extremity bypass the injury. The right lung is drained by the right lymphatic duct, not the TD (see one of the links bellow). And the heart is where eventually all the drainage is going to end up to be pumped again (TD -> LSV -> SVC -> heart). +17  
mbourne  To keep it simple, the Thoracic Duct drains lymph from the entire body EXCEPT for 3 structures: Right Upper Extremity Right Thoracic Cavity Right Side of Head and Neck These 3 areas are drained by the Right Lymphatic Duct which enters the Right Internal Jugular Vein +9  



 +7 
submitted by hayayah(1100),
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hTe ltef ruepp rymtxiete nad rsebta are ainrded by the lxyaalir yplhm noed. hTe nikdye si deadirn by teh occrhtia udc.t eTh rtahe sah tsi onw mpyhl msesty gonig on rnsugonruid teh thr.ae

l7673  My guy +  
l7673  -lalli +  



 +4 
submitted by onyx(43),
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Teh mass cdeirbsed is ni hte roitrospe immsneduiat e(se aesgim ol).ebw hTe aciorcht tcud si megdaad neβ€œar the ”s,ams ehcne aiadrgne fo gasonr itlasd ot htta pnoti wlli be d.ffcteae heT isaegm lbewo suldoh fiycalr.




jointaccount  Left breast & L UE drained by axillary. With the remaining choices, R kidney is the only choice outside the territory of the right lymphatic duct +  



 +2 
submitted by onyx(43),
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oaciTcrh ucdt loeasin.rt




 +1 
submitted by onyx(43),
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aleniaitMsd noiaser.tl




 +1 
submitted by divya(63),
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ofr tmaonay eusmdmi ielk fysmle




 +0 
submitted by consuela_salon(25),
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hisT saw eth tcrpieu atht I dklie eht tmso fro hsti oi.nuetsq fI uoy naeigim taht eth yjirun is ta het vleel of eht flet acbauivlns nive VLS)( and iocarthc cutd (T)D gicrossn each rhteo, ybeam it lliw plhe you izlreae that teh tfle bteras m&a;p tlef prupe yitxeremt passyb eht njuiry. heT hrgti gunl si eddanir by teh rithg apilhcmty t,ucd tno eth DT (see eno fo hte nliks lelo).wb dAn hte tahre si hwree uyneltalev lal eht iearangd si oigng to ned up ot be demupp niaag D(T t&;g- LVS &;tg- CVS gt-;& ae.rt)h

consuela_salon  (I meant the picture posted by onyx) +